Experts debate pros, cons of requiring flu vaccination
Most experts agree that offering flu vaccinations is a good idea, but the issue of requiring them can stir up a debate.
A professional group that focuses on worker safety says mandatory shots are unnecessary for health care workers. The American College of Occupational and Environmental Medicine (ACOEM) in Elk Grove Village, IL, recently issued a position statement that falls squarely on the side of employees who resist mandatory vaccination efforts. (Editor's note: The full position statement can be found on-line at www.acoem.org/guidelines/article.asp?ID=86.)
In that statement, ACOEM says it does make sense for health care employers to sponsor flu vaccination programs for employees and to encourage participation, but mandatory shots are a different matter. ACOEM points out that vaccinating employees does not prevent flu transmission to patients, who still will be exposed by friends and family.
ACOEM also notes that forcing employees to be vaccinated can harm the employer-employee relationship. The ACOEM position statement specifically cautions against requiring employees to sign a "declination statement," which signifies that they were offered the vaccine but refused. The declination statement is often seen as heavy handed and punitive by employees, ACOEM argues.
Best way to protect your staff?
On the other side of the debate is a hospital epidemiologist and flu expert who says mandatory vaccination of all health care workers is the best means of protecting patients and hospital staff from widespread outbreaks of the viral illness. Trish Perl, MD, MSc, an associate professor of medicine and pathology at The Johns Hopkins University School of Medicine in Baltimore, says mass vaccination policies are required to prevent patients from accidentally contracting the virus directly from an infected medical staff worker or indirectly from other patients or visitors via medical staff.
"We have gone as far as possible with vaccination programs emphasizing education and health promotion," Perl says. "It's now time to go the extra step, requiring active declination or even making vaccination a mandatory part of the job, linked to patient safety, along with such tasks as keeping hands clean and getting mandatory [tuberculosis] tests."
Perl says that hospital staff members tend to report that the most common reason cited for not getting a vaccination is a lack of time, and a surprisingly high number of staff members believe they could catch influenza from the flu shot, which is false.
How to make shots successful
To make a flu shot program successful, Perl recommends free shots for all staff, easy access to flu shot clinics on site, flexible vaccination hours, emphasis on patient safety aspects of the program, education to counter beliefs that the shots can make you sick, and encouragement from hospital leaders to get the vaccine.
Perl's position is backed up by the Association of Professionals in Infection Control and Epidemiology (APIC) in Washington, DC, which recently endorsed mandatory flu vaccinations for health care workers who have direct contact with patients. In a statement, APIC president Sue Sebazco, RN, CIC, explained that it concerns APIC that "a mere 36%" of health care workers opt for vaccination. "Even those health care facilities that promote immunization through aggressive voluntary campaigns show that 30%-50% of health care workers remain unvaccinated," she said.
Sources
For more information on flu vaccinations, contact:
- Trish Perl, Johns Hopkins University School of Medicine, Department of Medicine-Division of Infectious Diseases, Osler 425, 600 N. Wolfe St., Baltimore, MD 21287. Telephone: (410) 955-8384.
- Sue Sebazco, President, Association of Professionals in Infection Control and Epidemiology, 1275 K Street N.W., Suite 1000, Washington, DC 20005-4006. Telephone: (202) 789-1890. Web site: www.apic.org.
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